Rectal staging is necessary for the preoperative assessment of intra- and extramural tumor infiltration or the decision for adjuvant radio-chemotherapy. One indication of MRI with luminal contrast enhancement is small bowel enteroclysis after duodenal intubation for visualization of inflammatory bowel wall thickening and other complications.
"Double contrast" enhancement of the bowel lumen is the administration of plain water or water with methylcellulose along with heavily T2 weighted sequences or contrast enhanced T1 weighted sequences.
Several oral contrast agents have been used for small bowel MRI: Mannitol, metamucil, locust bean gum, and PEG. All provide sufficient bowel distension and homogeneity, but suffer from side effects such as diarrhea. The volume of PEG or mannitol administered must be not too large in order to achieve the best compromise between distension and acceptance by the patient.
MR colonography with positive bowel lumen enhancement requires higher concentrations of paramagnetic agents compared to the available dedicated enteral contrast agents, IV compounds are used to dope water enemas for this purpose.
Some investigators advocate negative bowel enhancement with Contrast Agents to suppress high signal bowel content in MRCP ( Magnetic resonance cholangiopancreaticography ). The use of a mixture of metamucil and 20 ml of gadolinium chelate provides good homogeneity and good tolerance without diarrhea.

General MRI of the abdomen can consist of T1 or T2 weighted spin echo, fast spin echo (FSE, TSE) or gradient echo sequences with fat suppression and contrast enhanced MRI techniques. The examined organs include liver, pancreas, spleen, kidneys, adrenals as well as parts of the stomach and intestine (see also gastrointestinal imaging). Respiratory compensation and breath hold imaging is mandatory for a good image quality.
T1 weighted sequences are more sensitive for lesion detection than T2 weighted sequences at 0.5 T, while higher field strengths (greater than 1.0 T), T2 weighted and spoiled gradient echo sequences are used for focal lesion detection. Gradient echo in phase T1 breath hold can be performed as a dynamic series with the ability to visualize the blood distribution. Phases of contrast enhancement include the capillary or arterial dominant phase for demonstrating hypervascular lesions, in liver imaging the portal venous phase demonstrates the maximum difference between the liver and hypovascular lesions, while the equilibrium phase demonstrates interstitial disbursement for edematous and malignant tissues.
Out of phase gradient echo imaging for the abdomen is a lipid-type tissue sensitive sequence and is useful for the visualization of focal hepatic lesions, fatty liver (see also Dixon), hemochromatosis, adrenal lesions and renal masses. The standards for abdominal MRI vary according to clinical sites based on sequence availability and MRI equipment. Specific abdominal imaging coils and liver-specific contrast agents targeted to the healthy liver tissue improve the detection and localization of lesions.
See also Hepatobiliary Contrast Agents, Reticuloendothelial Contrast Agents, and Oral Contrast Agents.

For Ultrasound Imaging (USI) see Abdominal Ultrasound at Medical-Ultrasound-Imaging.com.

Biphasic oral contrast agents may produce either high or low signal intensities depending on the pulse sequence used, for example low signal intensity on T1 weighted MR images and high signal intensity on T2 weighted images. The combination of different oral contrast agents can generate a macroscopic cancellation of negative and positive magnetic susceptibility, thereby eliminating susceptibility artifacts.
Possible combinations are e.g., ferric ammonium citrate and corn oil, or ferrous sulfate emulsified with baby formula. Paramagnetic agents combined with oil emulsion may be used in MRI as positive abdominal contrast agents. The combination of diamagnetic barium sulfate and superparamagnetic iron oxide (SPIO) in one suspension may be a useful negative contrast agent.

See also Gastrointestinal Paramagnetic Contrast Agents, Gastrointestinal Superparamagnetic Contrast Agents, Gastrointestinal Diamagnetic Contrast Agents, Gastrointestinal Imaging.

Paramagnetic substances, for example Gd-DTPA solutions, are used as MRI oral contrast agents in gastrointestinal imaging to depict the lumen of the digestive organs. Different Gd-DTPA solutions or zeolites containing gadolinium can be used e.g., for diagnosis of delayed gastric emptying, diagnosis of Crohn's disease etc.
Low concentrations of gastrointestinal paramagnetic contrast agents cause a reduction in T1 relaxation time; consequently, these agents act on T1 weighted images by increasing the signal intensity of the bowel lumen. High concentrations cause T2 shortening by decreasing the signal, similar to superparamagnetic iron oxide. Gd-DTPA chelates are unstable at the low pH in the stomach, therefore buffering is necessary for oral use.

See also Gadopentetate Gastrointestinal, Gadolinium Zeolite, Negative Oral Contrast Agents, Gastrointestinal Superparamagnetic Contrast Agents, and Ferric ammonium citrate.

Categories of negative oral contrast agents:
Negative oral contrast media are usually based on superparamagnetic particles and act by inducing local field inhomogeneities, which results in shortening of both T1 and T2 relaxation times. Superparamagnetic contrast agents have predominant T2 weighted effects. Biphasic contrast media are agents that have different signal intensities on different sequences, depending on the concentration at which they are used.
Suitable materials for oral contrast agents should have little or no absorption by the stomach or intestines, complete excretion, no motion or susceptibility artifacts, affordability, and uniform marking of the gastrointestinal tract. Benefits of negative oral contrast agents are the reduction of ghosting artifacts caused by the lack of signal. Superparamagnetic iron oxides produce also in low concentrations a noticeable signal loss; but can generate susceptibility artifacts especially in gradient echo sequences. Perfluorochemicals do not dilute in the bowel because they are not miscible with water.
High cost, poor availability, and limited evaluations of side effects are possible disadvantages.
Negative oral contrast agents are used e.g., in MRCP, where the ingestion of 600-900 ml of SPIO cancels out the signal intensity of the lumen (in addition after the injection of a gadolinium-based contrast medium, the enhancement of the inflammatory tissues is clearer seen), and in MR abdominal imaging of Crohn's disease in combination with mannitol.

Blueberry or pineapple juices are useable for examinations of the pancreas (MRCP, upper abdominal imaging) as cheep contrast agents, because of the content of magnetic substances (e.g. manganese).

See also Ferristene, Ferumoxsil, Oral Magnetic Particles, Gastrointestinal Imaging.